Boston.Tacmedic
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No not causing a Fx, I mean using it with a Cx Fx that is unseen
EJ or IO during a full arrest?
- Thread starter emtchick171
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No not causing a Fx, I mean using it with a Cx Fx that is unseen
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emtchick171
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I understood what you meant, sorry I didn't make it clear when I posted a reply. My fault, sorry for the confusion.
As far as I know, both are permitted in NJ, though IO is used mainly on children and in the case of unavailability of IV access. Long bone only for IO, no sternal. I've never seen a medic go for the EJ, but since it's a peripheral vein, I don't see why they couldn't.
They're talking about removing ET tube as a route of administration. I've only seen it done once - patient with bilateral femur and humerus fractures. No IV, no IO. Got one epi in down the tube. Of course, he also had bilateral hemopneumo, so I'm not sure how much good it did.
They're talking about removing ET tube as a route of administration. I've only seen it done once - patient with bilateral femur and humerus fractures. No IV, no IO. Got one epi in down the tube. Of course, he also had bilateral hemopneumo, so I'm not sure how much good it did.
Aidey
Community Leader Emeritus
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Sounds like that patient had a serious case of dead.
He was having what you might call a really bad day.
As you well know, nobody dies in the ambulance. At the scene, or in the hospital, yes, but not in the ambulance. So, when he coded half-way to the Trauma Center, we had to work it.
and yet you didn't call Brown to come swan out the sky in orange suit and go "yep, he's dead now lets go get something to eat"?
Despite the fact that I've had two cases in the last two weeks of nursing homes performing CPR on breathing patients (the latter of which was sitting up and talking to me when I arrived), we generally don't pronounce breathing patients. :wacko:
And alas, your helicopter was too far away. 18 minutes out as we loaded the patient, as I recall, and the hospital was about 20-25 minutes.
You should have told Ambulance Communications, Brown would have hopped in the car and come for a blast thru rural NJ at 120 miles an hour
Come on Oz, its a go, you can drive!
wyoskibum
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definately IO
Unless there is a contraindication, I prefer to use the Easy IO. Between compressions and ventilations, there is a lot going which makes it harder to get in there and start an EJ.
Unless there is a contraindication, I prefer to use the Easy IO. Between compressions and ventilations, there is a lot going which makes it harder to get in there and start an EJ.
Ridryder911
EMS Guru
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I believe we will see the abolishment of EJ's overall. More and more research are beginning to demonstrate multiple risks of air embolism, high incidence of infiltration (subdermal hematoma are very risky in that area), and infection rate in comparision to the I/O route.
As one that has performed literally huindreds of EJ, yes they are easy to cannulate, yes it is a large acess and venous route.. hence the complication associated with them. Now, with the introduction of easiness of I/O and very little associated risks in comparrision why continue to perform a procedure that has those associated complications?
R/r 911
As one that has performed literally huindreds of EJ, yes they are easy to cannulate, yes it is a large acess and venous route.. hence the complication associated with them. Now, with the introduction of easiness of I/O and very little associated risks in comparrision why continue to perform a procedure that has those associated complications?
R/r 911
Our Paramedics (ILS) are still taught EJs and have been doing them for years but Brown thinks they will probably go away in the future along with lasix.
We have used the BIG and Cooks screw-in IO needle for years and have introduced the EZIO last year however ... they are reasonably expensive and with ease of insertion comes the risk of the sparkier Officers whipping it out inappropriately when they cannot get a line into somebody.
We have used the BIG and Cooks screw-in IO needle for years and have introduced the EZIO last year however ... they are reasonably expensive and with ease of insertion comes the risk of the sparkier Officers whipping it out inappropriately when they cannot get a line into somebody.
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emtchick171
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IO definitely made EJ around my area go almost nonexistent...due to the fact of the ease and reliability of an IO. Also, Lasix is already strict...we do carry it on the truck, but we ALWAYS have to call medical direction in order to administer Lasix to a PT.
jonmedic101
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Io
I use IO very very often. I don't waste any more time today if I sense it will be hard to get an appropriate IV fast.
I prefer the BIG over the EZ, since it is not operated by batteries, its small size and comfort of use.
I can put some of these units in my vest and use even on MCI. for me holding to that case the EZ has is not comfortable.
This is how we do IO in Israel, and as you all probably know..... in Israel there a lot of scenarios requiring the use of the BIG for IO.
Jonmedic101
I use IO very very often. I don't waste any more time today if I sense it will be hard to get an appropriate IV fast.
I prefer the BIG over the EZ, since it is not operated by batteries, its small size and comfort of use.
I can put some of these units in my vest and use even on MCI. for me holding to that case the EZ has is not comfortable.
This is how we do IO in Israel, and as you all probably know..... in Israel there a lot of scenarios requiring the use of the BIG for IO.
Jonmedic101
TransportJockey
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In NM it used to be EMT-Is could only do Pedi IOs, but that may have changed. In TX I can do an IO anywhere and on anyone that I see that need.
lightsandsirens5
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IO here. Fast, easy, clean, very secure, all that good stuff. In an arrest, I don't want to dilly around with positioning his head to see the vein. Or have someone doing CPR enough to pressurize the vein and have to hit it while the pt is being bounced up and down. IO it like, ok, hold for one sec........locate site........zip! Ok, resume. Literally that long.
And can't you can just as easily bag a pt and push drugs thru a proximal humeral IO.
humeral head is preferred IO location here per protocol. That said, I much prefer the EJ in an arrest, easier to secure in an arrest and very conveniently located near the airway.
As far as the risk of air embolism...full arrest in the prehospital setting has a relatively poor prognosis as is.
As far as the risk of air embolism...full arrest in the prehospital setting has a relatively poor prognosis as is.
jjesusfreak01
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Lasix has been gone for a long time now here and IOs are the preferred method.